Malnutrición, disfagia, anorexia, sarcopenia y obesidad sarcopénica

Abstract

Malnutrition and its determinants (anorexia of aging, dysphagia, and sarcopenia, including sarcopenic obesity) are highly prevalent geriatric syndromes with significant clinical, functional, and prognostic implications for older adults. This update reviews the current evidence on the screening, diagnosis, and comprehensive management of malnutrition in older adults from a clinical and functional perspective. It also reviews the main nutritional screening tools in geriatrics and their integration with the GLIM diagnostic criteria. It analyzes anorexia of aging and dysphagia as key nutritional risk factors as well as sarcopenia and sarcopenic obesity, including their assessment using body composition techniques and their relationship to functional decline, dependency, and mortality. Finally, it summarizes the principles of management, which are based on multimodal interventions focused on personalized nutrition, multicomponent exercise, and a selective use of emerging pharmacological therapies. Systematic nutritional assessment, integrated into comprehensive geriatric assessment, is essential for the early identification and treatment of malnutrition and its determinants. A multidimensional and individualized approach improves functional status and reduces dependence and mortality in older adults.